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題 名 | Foreign Bodies in Tracheobronchial Tree in Children:A Review of Cases Over a Twenty-Year Period=兒童氣道異物:二十年回顧 |
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作 者 | 葉隆慶; 李學禹; 黃俊生; | 書刊名 | 長庚醫學 |
卷 期 | 21:1 1998.03[民87.03] |
頁 次 | 頁44-49 |
分類號 | 417.6891 |
關鍵詞 | 氣道異物; 支氣管鏡; Airway foreign bodies; Bronchoscopy; |
語 文 | 英文(English) |
中文摘要 | 背景:氣道異物雖然罕見,但對兒童而言、卻須及早診斷及處理,以避免不必要 的併發症,甚至導致死亡。 方法:本篇統計長庚紀念醫院耳鼻喉科自1976年7月至1996年6月,20年間共81位兒童氣道 異物。 結果:統計結果為男性61例,女性20例,年齡以3歲以下居多,佔82%。其中53(68%)個病例 是因花生之誤食造成,佔最多數。臨床症狀以咳嗽、呼吸困難及喘鳴較常見。氣道異物之 位置以左側支氣管較多。術前診斷包括胸部X光及軟式支氣管鏡檢查,以確定氣道異物之 位置及種類。在全身麻醉下以通氣式硬式支氣管鏡夾出異物,其中有6位病患因異物殘留 須再次手術以取出異物。患者術後皆康復出院,無嚴重併發症或死亡。 結論:兒童氣道異物在耳鼻喉科屬急症且必須立刻處理,診斷氣道異物最重要是靠病史詢 問。如何做好兒童居家保健以避免異物之誤食乃當務之急。 |
英文摘要 | Background: Foreign body inhalation into the tracheobronchial tree of children is rather rare but serious problem. It may be hazardous and even cause fatal sequelae in the children if misdiagnosed and not managed promptly. Methods: We retrospectively reviewed the records of 81 patients with foreign bodies inhaled into the larynx, trachea and bronchi. The children were all treated during the 20-vear period from July 1976 through June 1996 at Chang Gung Memorial Hospital. Of these patients, 82% were 36 months of age or younger. The male to female ratio was 3:1. All of the patients initially received flexible fiberoptic bronchoscopy to identify the foreign objects. The foreign bodies were removed by jet ventilation bronchoscopy, with apneic techniques under general anesthesia. Results: Peanuts were found to be the most common causative foreign body agent which occurred in 53 instances (65%). The most common manifestation was coughing, with subsequent dyspnea and audible wheezing. The foreign bodies were lodged in the left bronchus more than in the right. The most obvious radiologic evidence observed in aspirated children were emphysematous changes at same side of the foreign bodies caused by "expansile check-valve" phenomenon. Four patients showed radio-opaque objects on chest roentgenograms. Six patients required second extraction procedures due to the retained foreign bodies. Neither serious complications nor deaths occurred in these patients due to the foreign body inhalation. Conclusion: Early diagnosis and management is essential in children with foreign bodies in the airways to prevent morbidity or death. Small materials or food bits should be kept far away from young child. |
本系統中英文摘要資訊取自各篇刊載內容。